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Service & Repair Request Form
Tenant's Name
*
Building Address
*
2216 Adams Place
2428 Beaumont Avenue
660 Crescent Avenue
2246 Webster Avenue
2247 Webster Avenue
2249 Webster Avenue
440 East 182nd Street
1329 College Avenue
1365 College Avenue
1374 College Avenue
1378 College Avenue
1350 Ogden Avenue
163 West 170th Street
1791 Prospect Avenue
756 East 175th Street
2270 Washington Avenue
480 East 183rd Street
2183 Washington Avenue
4470 Park Avenue
2386 Bathgate Avenue
469 East 184th Street
517 East 187th Street
1772 Weeks Avenue
1776 Weeks Avenue
1814 Weeks Avenue
1360 Nelson Avenue
1385 Nelson Avenue
982 Prospect Avenue
1051 College Avenue
1055 College Avenue
1106 Morris Avenue
1114 Morris Avenue
1330 Morris Avenue
280 E. 166th Street
2029 LaFontaine Avenue
579 East 178th Street
586 East 179th Street
611 East 178th Street
2045 Southern Blvd
2319 Crotona Avenue
4691 Park Avenue
547 East 180th Street
1993 Bathgate Avenue
4424 Park Avenue
380 East 173rd Street
1068 Findlay Avenue
1694 Clay Avenue
1216 College Avenue
1069 Walton Avenue
315 East 170th Street
369 East 169th Street
1106 College Avenue
1105 College Avenue
1130 College Avenue
1114 College Avenue
2037 Webster Avenue
758 East 168th Street
764 East 168th Street
1091 Prospect Avenue
1421 Prospect Avenue
1279 Rev. Polite Avenue
25 Elliot Place
1993 Morris Avenue
565 East 178th Street
2131 Clinton Avenue
2089-91 Arthur Ave
62-66 West Tremont
Apartment Number
*
Contact Phone
*
Email Address
*
Apartment Overview
Number of
Bedrooms
Number of
Bathrooms
Fire Safety
Missing Smoke Detector
Missing Carbon Monoxide Detector
Kitchen
Refrigerator:
Defective or
Broken
Stove:
Defective or
Broken
General:
Peeling Paint
Ceiling Falling/ Fell
Cracked/ Bulging Walls
Ceiling Leaking
Hole in the Wall
Electricity Defective
Mold on Walls
Electricity Wiring Exposed
Water Damage
Outlets Defective
Loose Floor Tile
Sink Cracked
Baseboards Defective
Faucets Not Working
Window Frame Defective
Pipes Leaking
Door Broken
Leaking Faucet
Radiator/Raisers Leaking
Drain Stoppage
Living/Dining Room
Peeling Paint
Cracked / Bulging Walls
Hole in the Wall
Mold on Walls
Water Damage
Loose Floor Tile
Baseboards Defective
Window Frame Defective
Door Broken
Radiator / Raisers Leaking
Ceiling Falling / Fell
Ceiling Leaking
Electricity Defective
Electricity Wiring Exposed
Outlets Defective
Pipes Leaking
Bedroom(s)
Peeling Paint
Cracked / Bulging Walls
Hole in the Wall
Mold on Walls
Water Damage
Loose Floor Tile
Baseboards Defective
Window Frame Defective
Door Broken
Radiator / Raisers Leaking
Ceiling Falling / Fell
Ceiling Leaking
Electricity Defective
Electricity Wiring Exposed
Outlets Defective
Pipes Leaking
Bathroom(s)
Peeling Paint
Cracked / Bulging Walls
Hole in the Wall
Mold on Walls
Water Damage
Loose Floor Tile
Baseboards Defective
Window Frame Defective
Door Broken
Radiator / Raisers Leaking
Ceiling Falling / Fell
Ceiling Leaking
Electricity Defective
Electricity Wiring Exposed
Outlets Defective
Pipes Leaking
Toilet:
Not Working
Leaks
Slow Flushing
Cracked
Pipes Leaking
Broken / Missing Toilet Seat
Broken Toilet Paper Roller
Won't Flush
Tub/Shower:
Not Working
Inadequate Water Supply
Cracked Tile
Faucet Leaking
Shower Head Leaking
Knobs Broken / Missing
Clogged Drain
Sink:
Not Working
Inadequate Water Supply
Cracked Tile
Faucet Leaking
Knobs Broken / Missing
Clogged Drain
Public Areas & Building Grounds
Entrance Door
Door Missing
Hole In Door
Lock Defective
No Lock
Intercom Not Working
Broken Door
Not Self-Closing
Garbage
In Hallways
In Stairways
In Lobby
Mailboxes
Broken Garbage Cans
Missing Garbage Cans
Missing Garbage Can Lids
Lighting
Inadequate Lighting
No Lighting
Missing Fixtures
Broken Light
Explain Where...
Other Issues
